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Cyclooxygenase 2 (Cox 2) Expression in Newly Diagnosed Plasma Cell Myeloma: A Clinicopathological and Immunohistochemical Study on 73 Cases from a Single Tertiary Care Center

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

To study the cyclooxygenase 2 (Cox 2) expression in newly diagnosed plasma cell myeloma cases by immunohistochemistry (IHC) and correlate with clinicohematological characteristics. Immunohistochemical expression of Cox 2 on bone marrow trephine biopsy was studied in seventy-three newly diagnosed myeloma cases [56 males, 17 females, median age; 58 years (36–75)] and fifteen controls using SP21 clone antibody. A median immuno-score (proportion x intensity) stratified the entire cohort into low and high expressors. Cox 2 immunoexpression was compared and correlated with clinicolaboratory characteristics and marrow histomorphology and survival. Twenty one of 73 (38.7%) cases had a plasmablastic morphology whereas remainder fifty-two (61.3%) had a differentiated morphology. The Cox 2 expression was noted in 71/73 (97.2%) cases (median score = 127.3) and 15/15 (100%) controls. Low expressors was associated with higher circulating plasma cells, increased marrow tumor burden, blastic morphology, and lower proliferation index (p < 0.05) with a peculiar ‘dot-block’ cytoplasmic positivity (p < 0.001); whereas high expressors had thinned out bony trabeculae with granular cytoplasmic positivity with or without membrane accentuation (p < 0.001). Cox 2 expression had a weak negative correlation with tumor burden (r; -0.32, p = 0.01) and positive correlation with proliferation index (r; 0.29, p = 0.03). There was no statistically significant difference in the survival between low (n = 20) and high (n = 23) expressors (log rank p = 0.11). A high proportion of myeloma cells in our cohort expressed Cox 2 using SP21 clone; and this may have a role in futuristic research and therapy.

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Acknowledgements

The authors would like to thank the contribution made by Sk Samiur Raheman, Jaydev Patra, and Nihar Ranjan Das of Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar for their technical assistance in carrying out immunohistochemistry in all the cases. Also, the authors would like to thank Vasundhara Raina, PDF, Department of Clinical Hematology and Laboratory Sciences, Tata Medical Center, Kolkata for her statistical assistance.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

    Sandeep Abhijit Pattnaik & Somanath Padhi

  2. Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India

    Ashutosh Panigrahi

  3. Department of Public Health Dentistry, SCB Dental College and Hospital, Cuttack, India

    Gaurav Sharma

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  1. Sandeep Abhijit Pattnaik
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  2. Somanath Padhi
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  3. Ashutosh Panigrahi
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  4. Gaurav Sharma
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Contributions

SAP: Data collection, analysis and interpretation of data, literature review, and writing of first manuscript draft. SP: Conceptual design, literature review, data acquisition and interpretation, review of manuscript for intellectual content. AP: Provided the data pertaining to clinical and lab investigation, management and follow up, and reviewed the manuscript for intellectual content. GS: did statistical analyses.

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Correspondence to Somanath Padhi.

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The authors declared that they have no conflict of interest.

Ethics Approval

The Institutional Ethics Committee at All India Institute of Medical Sciences, Bhubaneswar approved the study protocol, and this study was conducted in accordance with the Declaration of Helsinki.

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This manuscript was presented, in part, as an Oral Paper for JC Patel Oration Award session at 60th National Annual Conference of Indian Association of Hematology and Blood Transfusion (ISHBT), held at New Delhi, India during November 2019.

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Pattnaik, S.A., Padhi, S., Panigrahi, A. et al. Cyclooxygenase 2 (Cox 2) Expression in Newly Diagnosed Plasma Cell Myeloma: A Clinicopathological and Immunohistochemical Study on 73 Cases from a Single Tertiary Care Center. Indian J Hematol Blood Transfus 38, 235–245 (2022). https://doi.org/10.1007/s12288-021-01448-3

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  • DOI: https://doi.org/10.1007/s12288-021-01448-3

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